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A guide to
nutrition


What are
functional foods?

Probiotics &
your health

Obesity –
an Irish epidemic

Nutrition & pregnancy

Your digestive system

The role of vitamins & minerals

Finland – a case
study in healthy
eating


Health Calculators

 

 


How important is pre-pregnancy nutrition?
What about nutrition during pregnancy?
What about morning sickness?
What about tiredness?
What about cravings?
What about constipation?
What about haemorrhoids?
What about heartburn?
What are a pregnant woman’s unique energy requirements?
What foods represent a danger to pregnant women?
What about women who are breastfeeding?


How important is pre-pregnancy nutrition?
Folic acid
Even before a woman becomes pregnant, what she eats is very important for the healthy development of her baby in her womb in the future. This is all the more so as she may be pregnant before she even realises it, during a crucial time in the baby’s development.

Folic acid, which is also known as folate, is a form of vitamin B. Like most other vitamins, it cannot be made in the body, so it must be taken either in dietary form or as a supplement. Folic acid plays an important role in the growth of the baby in early pregnancy.

Foods rich in folic acid (or folate), should be eaten both before becoming pregnant and in the first three months of pregnancy as folate has been shown to reduce the risk of having a baby with a neural tube defect such as spina bifida.

Spina bifida is a lesion that affects the spine and the spinal cord and it may result in severe disability for the remainder of the child’s life. The incidence of neural tube defects is higher in Ireland than in other European countries and the relative deficiency of folate in our diet contributes to this.

The recommended intake is 400 microgrammes a day and sources of folate include liver; yeast extract; green leafy vegetables; cabbage; cauliflower; broccoli; Brussels sprouts; lettuce, spinach, green beans; peas; potatoes; bread; bananas; oranges; grapefruit; brown rice; eggs; carrots; nuts; and fish. Many bread and cereal products are now also fortified with folic acid along with milk.

Women at high risk, particularly those who have previously had a child with a neural tube defect, should take a higher dose of folate. Your doctor will advise you about this.


What about nutrition during pregnancy?
When a woman becomes pregnant, her energy requirements increase to meet the needs of the unborn baby, her growing womb and the placenta, which is the main source of transmission of nutrients from the mother to the baby.

The baby’s development is ongoing while it is in the mother’s womb and it depends on an adequate supply of nutrients at various stages of pregnancy to ensure that it develops properly.


What about morning sickness?
Even before a woman actually looks pregnant, she will have a number of symptoms telling her that she is expecting a baby. Among these is morning sickness, a feeling of nausea which occurs in the earlier part of the pregnancy and which is thought to be caused by a surge in hormones in the woman’s body as a result of her pregnancy. It is thought that a high level of the hormone oestrogen, low blood glucose in the morning, high levels of digestive juices and increased activity of the liver all contribute to morning sickness. Iron supplements may also worsen the problem and it may be helpful to take them with food Low blood pressure, deficiency of vitamin B6 and iron or excessive amounts of fatty foods or spices can aggravate the condition.

The term morning sickness is something of a misnomer, as it can occur at any time, especially when the woman is tired or hungry. It usually passes off as the pregnancy progresses (by 14-16 weeks) but it can interfere with a woman’s nutritional intake.

Some women find that it can help to eat a carbohydrate-rich food such as dry toast or a cracker or biscuit about 20-30 minutes before they get up in the morning to help settle their stomach. A peeled apple or a peeled, cooked potato can also help. Protein-rich foods may also help. Fatty foods are nauseating and should be avoided, however.

It can also help to try to continue to eat small meals regularly rather than just three big meals a day. It can also help to avoid spicy food and to avoid drinking liquids with her meals. Ginger biscuits or ginger ale can help symptoms of nausea.

Women with morning sickness should also drink plenty of water as this neutralises stomach acid and replaces any fluids lost by vomiting. Fizzy drinks which have been allowed to go a little flat can also help. Peppermint tea can help too, as can icepops, jelly or clear broth.


What about tiredness?
Another common symptom during early pregnancy is tiredness during the day, which can be alleviated by snacking between meals. Healthy options which provide energy over a longer period of time, such as fruit, crackers and cheese or a yoghurt, for example, are a preferable to foods which provide instant energy highs for a short period only, such as sweets or chocolate.

If the tiredness is related to anaemia, an iron supplement may be required, as iron needs are increased throughout the pregnancy. Your doctor will advise you about this. Anaemia means that the blood carries less oxygen to the placenta, which may lead to premature birth or low birth weight. It can also increase the risk of the mother bleeding at birth. If tiredness persists, consult your doctor for further advice.


What about cravings?
Some pregnant women may develop food cravings and may crave many unusual foods and indeed, other items, on occasion, including coal and ice chipped from the sides of the freezer! This condition is known as pica.

While we are not entirely sure the reason for the craving, there have been several suggestions. Some say that it is nature’s way of getting the required nutrients lacking in the diet, and may be associated with iron deficiency. Low blood sugar may also contribute to cravings. Whatever the reason, any food craved should be taken in moderation and excess should be avoided.


What about constipation?
One of the more unpleasant aspects of pregnancy is constipation, often due to the increased weight in the pelvis. Hormones released during pregnancy also have an effect on the bowel muscles, making them less elastic and therefore slowing down the transit of food through the gut, resulting in constipation. Iron supplements can also cause constipation, as can a reduction in the usual amount of exercise taken.

You should try to eat small helpings several times a day and eight to 10 glasses of water each day is also vital to help avoid constipation. A cup of warm liquid when you get out of bed may also help to stave off constipation. Regular gentle exercise for at least 20 minutes a day can also help, as it gently stimulates the bowel.

Fibre
Fibre helps to retain water in the faeces, ensuring that they don’t dry out and become hard and difficult to pass. The woman should eat whole grain and bran cereals and breads, along with plenty of fruits and vegetables. Stewed prunes, apricots and prune juice can also help, as can dried fruits, such as raisins and prunes.


What about haemorrhoids?
In the last three months of pregnancy, the pressure on the pelvis increases, causing congestion in the body and in the blood vessels. Coupled with constipation and excessive straining to pass faeces, this can result in haemorrhoids or piles. Piles - are are swollen blood vessels similar to varicose veins in and around the anus and lower rectum in the back passage. They are common among pregnant women and they can cause itching, soreness and bleeding.

Prevention involves avoiding constipation (see above)


What about heartburn?
Heartburn is the name given to the pain experienced when the acid from the stomach is pushed up into the oesophagus, the muscular tube leading from the throat to the stomach. It is caused by the pressure in the pelvis, which presses on the stomach as the baby grows in the womb and it can also result from the slow down in digestion. Another cause is the effect of the hormone progesterone, which can ‘soften’ the usually tight valve between the oesophagus (gullet) and stomach, which keeps the stomach acid from travelling back up the oesophagus.

It can help to eat small quantities several times a day to avoid the problem, or to avoid spicy or greasy foods and to refrain from eating anything for an hour before going to bed. Some women find that using several pillows at night can also relieve their problem, while others like to wear loose fitting clothes.

It may also help to bake or grill food instead of frying it and to avoid highly seasoned or fatty food. Avoid grapefruit juice or orange juice. Drink water, milk, apple juice or cranberry juice instead. Eating yoghurt can also help, as can a tablespoon of honey in a glass of warm water.

Avoiding soft drinks, coffee, hot chocolate and other drinks with caffeine can also help. Some women find that it helps to drink milk before mealtimes.

As with all health matters, if your physical change is more than a minor disorder tell your midwife or doctor.


What are a pregnant woman’s unique requirements?
Energy requirements during pregnancy
A pregnant woman gains weight and lays down extra fatty tissue during pregnancy, and weight gain of 10-12kg is common during a healthy pregnancy. Weight gain is normal and is vital for the health of both the mother and baby. If a mother fails to gain enough weight, the baby may be small when born. Low birth weight infants have a greater likelihood of developing health problems. However, if the mother gains too much weight, the baby may be too large, which can increase risk of health problems during pregnancy and make giving birth more difficult.

In the latter stages of pregnancy, from six months onwards, the woman needs to take in about an extra 200 calories a day. When she is breastfeeding, this increases to 500 extra calories a day.

Protein
The RDA of protein for pregnant women in the second half of pregnancy is 0.75g/kg body weight/day. A pregnant woman needs extra protein to allow her baby to develop properly and to meet her own needs as she develops extra body tissue.

Iron
Because of their unique energy requirements, pregnant women should ensure, if possible, that they eat at least three meals a day. Iron-rich foods are particularly important, as many women do not get enough iron in their diet, which is needed for healthy foetal development. The RDA of iron for pregnant women in the second half of pregnancy is 15mg/day.

A good source of iron is lean red meat which should be eaten three to four times a week. Fortified breakfast cereals, beans, eggs, apricots, prunes, figs, spinach and broccoli also contain iron.

Vitamin C
Vitamin C aids the absorption of iron from the diet, while tea will block its absorption of iron and so drinking tea should be avoided directly after an iron-rich meal. Vitamin C rich foods include oranges, tangerines, clementines, satsumas, grapefruits, lemons, limes, kiwi, blackcurrants, mangoes and nectarines. Any drink made from these fruits is also high is vitamin C. Potatoes are also a reasonably good source. The need for vitamin C increases by 33% during pregnancy and the RDA for pregnant and breastfeeding women is 80 mg/day. Choose two of the foods listed above to meet your daily vitamin C requirements.

Calcium
Pregnant women require an additional 40% of calcium a day and the RDA of calcium for pregnant women in the second half of pregnancy is 1200 mg/day. Almost all of the extra calcium goes into the baby's developing bones.

To get this extra calcium, 5 servings* of milk or dairy products are needed. Milk on cereal or as hot chocolate, a smoothie, a milkshake, cheese pizza or lasagne are also good sources. Calcium is also found in the soft bones found in tinned fish, in white bread and in small amounts of broccoli, cabbage and spinach (* a serving is equal too a glass of milk, carton of yoghurt or a matchbox-size piece of cheese).

Essential fatty acids
Mackerel, herring, salmon, sardines and kippers contain fats that are essential for the development of your baby’s brain and eyes. Aim to eat oily fish two to three times a week.

Coffee
The Food Safety Authority of Ireland recommends that pregnant women should limit their daily intake of coffee to 300mg, which is the equivalent of three mugs or four average cups of coffee.

One recent study in the British Medical Journal has shown that pregnant women who drink more than eight cups of coffee a day significantly increase their risk of having a stillborn baby. The study found that pregnant women who drank four to seven cups of coffee a day increased their risk of having a stillborn baby by 80%. Those who drank more than eight cups of coffee a day increased their risk of having a stillborn baby by 300%.

What foods represent a danger to pregnant women?

Some foods that ordinarily represent no danger to the woman can be dangerous to the baby and should therefore be avoided. These include alcohol, which should be avoided during pregnancy, as no level of alcohol consumption is considered safe during pregnancy. It's important to avoid food-borne illnesses when you're pregnant. Do not eat raw eggs, raw meat or fish, or cheeses that are not pasteurised, including soft cheese such as Camembert, Brie and blue veined cheese. Liver may also contain excessive amounts of vitamin A, which is dangerous to the baby.

Unwashed fruit and vegetables should also be avoided so take extra care when eating out, and only choose cooked fruit and vegetables. Peanuts are a possible allergen and should also be avoided.


What about women who are breastfeeding?
A woman who is breastfeeding needs about 500 extra calories a day to maintain a good supply of milk. Breastfeeding is very demanding and a breastfeeding woman needs an extra 11g of protein a day from birth of the baby until the baby is six months old and 8g a day afterwards, in order to maintain an adequate milk supply. She also needs an extra 1200 mg/day of calcium and 15mg/day of iron.
A good fluid intake is important and the woman should bear in mind that anything she eats or drinks, such as alcohol, is also ingested by the baby through her breast milk.

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Welcome | A guide to nutrition | What are functional foods? | Probiotics & your health
Obesity – an Irish epidemic | Nutrition & pregnancy | Your digestive system
The role of vitamins & minerals | Finland – a case study in healthy eating
Health Calculators